Dysmorphic Vertebral Body



Dysmorphic Vertebral Body


Julia Crim, MD



DIFFERENTIAL DIAGNOSIS


Common



  • Single Vertebral Body



    • Post-Traumatic Deformity


    • Schmorl Node


    • Limbus Vertebra


    • Metastases, Lytic Osseous


  • Multiple but not all Vertebral Bodies



    • Abnormal Segmentation



      • Partial Vertebral Duplication


      • Vertebral Segmentation Failure


      • Klippel-Feil Spectrum


    • Scheuermann Disease


    • Scoliosis


    • Metastases, Lytic Osseous


    • Juvenile Idiopathic Arthritis


    • Neurogenic (Charcot) Arthropathy


    • Post-Radiation Changes


  • Diffusely Abnormal Vertebral Bodies



    • Sickle Cell


    • Osteogenesis Imperfecta


    • Achondroplasia


Less Common



  • Single Vertebral Body



    • Kümmell Disease


    • Osteochondroma


    • Ewing Sarcoma


    • Langerhans Cell Histiocytosis


  • Multiple Vertebral Bodies



    • Osteomyelitis, Pyogenic


    • Osteomyelitis, Granulomatous


  • Diffusely Abnormal Vertebral Bodies



    • Thanatophoric Dwarfism


    • Mucopolysaccharidoses


ESSENTIAL INFORMATION


Key Differential Diagnosis Issues



  • Single vertebrae with abnormal appearance usually post-traumatic


  • 2 or more adjacent vertebrae with abnormal appearance usually segmentation anomaly


Helpful Clues for Common Diagnoses



  • Scheuermann disease causes undulating appearance of vertebral endplates


  • Cushing disease causes cupping deformity of vertebral endplates


  • Infection and neurogenic arthropathy are centered on intervertebral disc and show endplate erosions


  • Juvenile idiopathic arthritis results in vertebral bodies that are tall relative to anteroposterior diameter


  • Kümmell disease distinguished by gas in vertebral body


  • Sickle cell causes “Lincoln Log” deformity


  • Mucopolysaccharidoses and achondroplasia cause “bullet vertebrae” with anterior portion of body small


  • Vertebral bodies near apex of a scoliosis often mildly misshapen


  • Tumors involving only part of vertebral body may cause a dysmorphic appearance due to partial collapse


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Aug 7, 2016 | Posted by in NEUROLOGY | Comments Off on Dysmorphic Vertebral Body

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